The survey did not cover the reasons for the stress, but Ng said the top three factors were usually concerns over academic results, interpersonal relationships and family finances.

A separate study in May by the Hong Kong Playground Association showed a third of 3,177 Hongkongers aged six to 24 were suffering from stress, anxiety or depression.

According to the Hospital Authority, 32,000 children or teenagers were diagnosed with mental health problems in 2016 and 2017. Some 20,000 were below 12 years old.

Poon Cheuk-lam, 10, is usually at the top of her class. She said she would feel stressed out if not performing well in exams, largely due to worries about her parents being disappointed.

“Sometimes I worry that my grades are not good enough to get into a good school ... My mother would be a bit unhappy if I didn’t do well, but she always tells me it’s fine as long as I try my best,” Poon said.

Hong Kong pupils are under tremendous pressure to perform well academically in a school system that favours exams and long hours of rote learning.

The St James’ Settlement survey also polled 791 parents and found 78 per cent believed their children would open up to them about stress. However, only 25 per cent of the 807 pupils polled said they had.

“Usually, children from low-income families are more independent and try to handle it themselves if they feel they are capable,” Ng said.

Chow Suk-ping, a teacher at St Edward’s Catholic Primary School in Kwun Tong, said parents should learn to listen to their children before doling out punishments, advice or judgment.

Eighty underprivileged pupils from four primary schools have taken part in a pilot programme organised by St James’ Settlement and the AXA Foundation aimed at teaching children emotion management skills and better ways to cope with stress. The NGO plans to expand the programme to cover about 400 students in the next three years, if an application for a government grant is successful.